Analysis of therapeutic effect of combination semi joint prosthesis in treatment of malignant bone tumors around knee joint in adolescents
Objective To explore the efficacy and complications of combination semi joint prostheses in the treatment of malignant bone tumors around the knee joint in adolescents.Methods A retrospective analysis was conducted on 24 patients with malignant bone tumors around the knee joint who underwent limb salvage surgery and received follow-up at the Orthopedics Department of Fuwai Central China Cardiovascular Hospital from January 2018 to December 2021.All patients underwent preoperative biopsy to confirm their pathological diagnosis and completed preoperative chemotherapy in a standardized manner.The length of osteotomy was determined based on preoperative imaging examination.A combi-nation of semi joint prosthesis and LARS ligament was used to reconstruct bone defects,patellar ligament,and lateral collateral ligament.Results Totally 24 patients in this group were followed up for 30-60 months,with an average of(41±1.2)months.There were 19 patients with osteosarcoma,5 patients with Ewing's sarcoma,15 males,and 9 fe-males;the age range was 9-13 years,with an average of(12.4±0.7)years old.The lesions were located in 16 cases of the femur and 8 cases of the tibia.Osteotomy length of 13.3 cm,with an average 9-21 cm.Three cases(12.4％)died,two cases(8.33％)experienced postoperative lung metastasis,and five cases(20.83％)experienced prosthetic subluxation,which did not affect normal walking under the support of assistive braces;one case(4.17％)developed postoperative infection and healed after debridement.After 3 years of surgery,the average(18.3±1.2)score of the A-merican society of skeletal and muscle tumors(MSTS)was used,indicating good limb function.Conclusion For adolescents and children whose epiphyses have not yet closed,the combination of semi joint prostheses can preserve the contralateral epiphyses,and after the epiphyses are closed,they can be directly combined into a standard tumor type knee joint through secondary surgery,minimizing complications of limb inequality.
Malignant bone tumorsSemi joint prosthesisLimb salvage
NETL
NSTL
万方数据
